Vitreous Body

The vitreous body is the transparent substance inside the eye. In its consistency, the vitreous body resembles egg white. It is located between the lens and the retina and fills this space. The main component of the vitreous body is water, which is bound in a fine network of fibrils and hyaluronic acid. In youth and into adulthood, this water content is high, similar to a sponge, causing the vitreous body to completely fill the space in front of the retina.

Over the course of life, this water content decreases and the vitreous body contracts somewhat. This process is referred to as “vitreous degeneration.” The vitreous body detaches from the retina, which the ophthalmologist calls an “acute posterior vitreous detachment” — a common event in the lives of many people.

Those affected may perceive streaks, flies, threads, or passing shadows. Since connecting fibers from the vitreous body still extend into the retina, movement of the vitreous body can exert traction forces on the retina and cause light phenomena such as recurring light flashes.

During an acute vitreous detachment, these traction forces on the retina can also cause holes and larger tears. If you experience symptoms such as light flashes, streaks, soot rain, shadows, or similar phenomena, seek an ophthalmologist immediately to ensure that no retinal tears are present.

Retinal tears or smaller holes can be precursors to retinal detachment, and we are happy to inform you about the so-called SOS symptoms.

Floaters

Floaters or mouches volantes are caused by natural densifications of collagen fibrils and irregularities in the vitreous body and are present in most eyes. They can cause diffraction effects and cast shadows on the retina. They appear as transparent, moving, net-like, dot-shaped, worm-like, or cloud-like formations. These phenomena are particularly noticeable against bright backgrounds such as a white wall, snow, or a screen, where they appear with increased contrast. For many people, they are extremely bothersome, and in many cases, we can actively help. Unfortunately, there are no treatments through eye drops or medication, although pseudomedical products are offered on the market.

Diagnostics

Optical Coherence Tomography (OCT)

Optical coherence tomography (OCT) is the worldwide standard in the diagnosis of retinal diseases, especially of the macula, as well as optic nerve diseases such as glaucoma.

It has become a crucial tool in the diagnosis of macular diseases and is therefore the primary procedure for evaluating AMD, macular edema, macular holes, or so-called macular puckers.

The principle is based on measuring the reflected light beam in the eye and converting it into a visible image through digital technology. The resolution is 10 micrometers. This procedure is painless and completely harmless.

Optical coherence tomography is not part of the statutory health insurance benefits catalog. Therefore, this examination must be billed as a private medical service.

Optos Ultra – Wide-Angle Laser Scanning Technology

The Optos Ultra wide-angle laser scanning technology creates high-resolution, digital retinal images that support the early detection, documentation, and treatment of eye diseases as well as systemic conditions. In particular, it provides outstanding visualization of vitreous opacities.

In a single, quick capture, the Optos system covers a field of view of up to 200° (approximately 82%) of the retina. In comparison, conventional methods show only about 45° of the retina in a single image.

This technology was developed to protect people from visual impairment, blindness, and serious conditions such as diabetes, cancer, stroke, and heart failure. The Optos scan is not part of the statutory health insurance benefits catalog and must therefore be billed as a private medical service.

Treatment

Laser Vitreolysis for Floaters/Mouches Volantes

As a modern treatment method for mouches volantes, we offer our patients the floater laser treatment. The so-called laser vitreolysis (Nd:YAG vitreolysis) enables the fragmentation and dissolution of these phenomena. The Ellex Ultra Q Laser was specifically developed for this indication and uses a coaxial beam path, low energy, and a precise plasma cloud to vaporize the floaters.

In some rare cases, vitreous changes may exist that cannot be treated with the vitreolysis laser. In such individual cases, surgical options such as vitrectomy may be considered as therapy.

Prof. Dr. Koss is among the most experienced practitioners of laser vitreolysis in southern Germany and was the first in Munich to have the vitreolysis laser since 2015. Additionally, training courses for ophthalmologists on laser vitreolysis were held at the Eye Center Nymphenburger Höfe in 2016 and 2017.

Surgical Floaterectomy

In many clinical cases, a minimally invasive operation can provide a solution. After a 2 to 3-week rehabilitation period, your vision improves significantly, and no long-term consequences are expected following an uncomplicated surgery.

Through our outpatient surgical facility, we can perform floater removal under brief sedation for privately insured patients and self-payers, without you being consciously aware of the procedure. Before the surgery, it is important to discuss the circumstances and consequences of the operation (such as accelerated development of cataracts) and follow-up examinations with the referring ophthalmologist. For patients who have already had cataract surgery or received multifocal lenses and suffer severely from floaters, these considerations do not apply.

Important to note:

Floaters are not classified as an independent disease, therefore neither vitreolysis nor surgical floater removal are covered by statutory health insurance. Your private health insurance may require a corresponding co-payment. We are happy to inform you by email about the costs for preliminary and follow-up examinations as well as the respective therapy, but we emphasize that a personal assessment during an examination is essential.